Mechanistic and Clinical implications of Niacin in Diabetic Complications
Diabetes mellitus predisposes patients to a spectrum of microvascular and macrovascular complications. Niacin (vitamin B₃), a precursor of nicotinamide adenine dinucleotide and a therapeutic lipid-modifying agent, exhibits anti-inflammatory, antioxidant, and endothelial-protective actions. Biochemical and clinical studies suggest niacin may confer benefits in diabetic nephropathy, neuropathy, and dyslipidemia-related cardiovascular risk. However, clinical use remains constrained by concerns over worsened glycemic control, insulin resistance, and increased risk of developing diabetes. This review synthesizes mechanistic insights, animal and human data, and clinical trials to assess niacin’s therapeutic potential and safety in diabetes.